Bone Density: Questions for the Experts (x-post on RNY forum)

Edited because the first post was way too long.  Sorry!

Hi!  Does anyone understand the physical process and "normal progression" of bone density changes? What would you think and do about the DXA bone density test results I explain below?  I welcome anyone's thoughts who wants to weigh in on these questions.

Today I had my physician-scheduled DXA scan, related to my annual physical, looking at bone density in my lower back and hips as markers toward Osteoporosis. This was helpful because I could compare the results to last year's similar DXA scan for trends.

Some of you will remember that a month ago, I had a DEXA scan looking at whole body muscle/fat/etc, that was by a private fitness based company; today's test was a medical test done at my physician's clinic.  Same kind of machine, but a more focused look at bone density.

Today's results concerned me because they show what seems to me like quite a drop in density.  I am still well within the normal range, but am concerned about the trend.

I have been very diligent with my calcium supplements since surgery.  I have always taken Calcium Citrate. Although I do not drink milk, I do eat a lot of cheese and greek yogurt. I also take my high-quality multivitamins regularly. I am 52 years old, and I think I am in peri-menopause.  Having had a hysterectomy, I don't have periods anymore, but I still have my ovaries.

Questions:

What might explain the change in density?  I definitely would not want to see such a drop every year. 

Is a change in bone density possibly related to peri-menopause? 

Does bariatric surgery affect the bone density mechanism, in ways beyond calcium absorption?

Are there things in my diet that might be affecting calcium absorption?  Are there other things in my diet or life that might be affecting bone density mechanism besides the calcium?  (e.g., stress and cortisol?  Lack of nutrients from natural vegetable/fruit sources?)

What can I do to reduce this bone density drop?

this is my take on the bone issues: 

well.. we don't really know if we do and how much calcium we malabsorb..

in my research (very very extensive) I found out that calcium itself is not going to fix the bone issues.

too much  D and too much calcium is actually very bad for anyone... if the person does not have enough magnesium, boron, strontium, etc... and vit K2. Plus exercise - if you don't stress the bones - they get thinner... (the people in space - they loose bone density because there is no gravity in space... not because they don't take enough vitamins and minerals - that has been documented)

I take very little calcium... (relatively) and I don't drink milk or eat yogurt.. I started eating some cheese...but for 3 years I ate very little dairy...or greens.. and i am on daily steroids..(taht can cause bone loss)

But I am on HRT, and I take magnesium and K2 and trace minerals... and at 50+...my bones are very strong, healthy... I just had a DEXA scan done...

my D is around 60-70...that's where I want it to be... calcium -around 9-10; PTH -30...

this is what I found so far from my research:

if our D is high and we take a lot calcium - we absorb it... but then unless we have plenty of other minerals and vitamins - specially K2 - the body would put calcium everywhere but the bones.. that's how people end up with veins, arteries calcium deposits...  calcification... and stones... 

So far- my approach is working for me... except for my arms and ribs - my bones density is comparable with a young person.  My arms and ribs were always the weakest... even before RNY . It's time for me to do some weightlifting using my arms..

in 8 years since I had RNY - my bone density did not change much..

Very interesting thank you Hala. 

Hala, I really appreciate this response.  Very much.  It really got at some of my questions.  It made me feel I need to be more careful about not over-supplementing with calcium, and about seeking weight-bearing exercise.  From what I have read (even since making this post), menopausal hormone changes really do cause bone loss in that they disrupt our bone-cell regeneration process.

Thanks again!

And, thanks for reading my long post!  I went back and shortened it because it was Sooooooo long! 

xo